Adverse Childhood Experiences, Exposure to the World Trade Center Attacks, and Chronic Symptoms of Depression, PTSD, and Unhealthy Drinking

Details

• Journal Article:
  Journal of Affective Disorders
• Personal Author:
  Parcesepe, Angela M. ; Sanborn, Jenna ; Sisti, Julia S. ; Metzler, Janna
• Description:
  Background: Exposure to potentially traumatic events (PTE) is common and associated with poor mental health. Little is known about factors that influence the relationship between PTE and long-term mental health. Methods: This sample included 26,178 individuals who were 18 years or older on September 11, 2001, enrolled in the World Trade Center Health Registry, and completed the Wave 5 survey in 2020-21. We investigated the extent to which adverse childhood events (ACE) modified the relationship between WTC-related PTE exposure and the risk of prevalent or persistent symptoms of post-traumatic stress disorder (PTSD), depression, and unhealthy drinking on multiplicative and additive scales. For each outcome, we fit a log-binomial regression model including categorical variables for WTC-related PTE and ACE, their interaction, and covariates. Adjusted risk ratios were estimated for each joint level of PTE and ACE, using the doubly unexposed group (medium/low PTE and no ACEs) as reference. Results: ACE exposure and WTC-related PTE exposure were independently associated with greater risk of prevalent and persistent symptoms of PTSD, depression, and unhealthy drinking. There was evidence of positive additive and negative multiplicative modification by ACE exposure of the relationship between WTC-related PTE exposure and symptoms of persistent PTSD and depression. Conclusion: Findings suggest that adverse experiences in childhood increase the risk and persistence of symptoms of PTSD and depression after mass trauma in adulthood. Screening of traumatic events throughout the life course may increase identification of individuals at increased risk of poor mental health outcomes following subsequent PTE exposure.
• Subjects:
  Adverse Childhood Experiences Mental Health Occupational Health Safety September 11 Terrorist Attacks Stress Disorders, Post-Traumatic
• Keywords:
  Author Keywords: Trauma; Mental Health; Adverse Childhood Events; Depression; Alcohol; PTSD Mental Health; Post-traumatic Stress Disorder; PTSD; WTC; World Trade Center; Traumatic Incident Stress; Alcohol;
• Source:
  J Affect Disord 2026 Feb; 395(Pt A):120671
• ISSN:
  0165-0327
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; North Carolina ; Atlanta Region [OSHA] ; New York City Region [OSHA] ; New York City (NY)
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  WTCHP - World Trade Center Health Program
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  9 pdf pages
• Volume:
  395
• NIOSHTIC Number:
  nn:20071233
• Contact Point Address:
  Angela M. Parcesepe, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
• Email:
  angela_parcesepe@unc.edu
• Federal Fiscal Year:
  2026
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Part Number:
  A
• Start Date:
  20090430
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:20d5c253bd12c3f529f2eba41f64e51a3b0f5df7761bab66e9436fa43423327f9518204fbadc40cdeade59c1b86ea5425e8aeb46d1ddfe134767ff96d516fc9d
• Download URL:
  https://stacks.cdc.gov/view/cdc/258711/cdc_258711_DS1.pdf
• File Type:
  [PDF - 626.52 KB ]